My 5 yr old son repeats full words. Should I be concerned?

Q.  My 5yo son has a rather odd speech pattern. He will repeat a word over and over until the next word comes to mind and he can continue his narrative. It isn't a syllable or a sound but a full word and it is random. It is almost always present but certainly more evident when he is making up a story or excited to tell me something. Should I worry and is there anything I should do? Thank you

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A.  Thanks for the question.  Its a good one that many parents see and wonder about. 

Disclaimer:  It is difficult to make clinical judgements from short descriptions of behavior and minimal history without seeing a child. However, I will give you my recommendations to the best of my knowledge based on the presented information.  I urge you to follow up with a speech language pathologist in your area for additional assistance as needed.

What should I do about stuttering?

From your description, it sounds like your child's primary use of dysfluencies (stuttering) is for word retrieval.  It is not uncommon for children to use word or phrase repetitions as a delay technique in order to correct their grammar or vocabulary in their minds prior to vocalizing (I encourage you to read my blog on Typical Dysfluencies for further explanation).  With that said there are several things you can do at home to encourage fluency which I will discuss now (please see my blog on What you can do right now to improve your child's fluency for further techniques not mentioned here today.):

• Slow Down:  when you slow your rate of speech down, saying each word slowly, with ease, pausing between every couple of words, your child will respond accordingly using a slower rate of speech which will give his brain some time to sort through vocabulary and retrieve the correct word for which he is looking.  Do this especially when he seems excited and really wants to tell you something: 1.)Lower your body so you are eye to eye with him (giving him the sense he has your full attention), 2.) lower your volume (to a quiet one on one conversation level, giving him the sense that he HAS time to tell you his story...there is no urgency), 3.) and then finally slow your rate (your imitation of a slow rate will relax him and help him to slow his rate).
• Don't Interrupt:  Please please don't interrupt your child or try to "give him" the word he is searching for.  Although we want so desperately to help our children, this just gives him a sense of urgency, that he must say things quickly or he will loose your attention.
• Don't forget the praise:  "Wow, I see it was hard for you to find that word, but you took your time and found it!  I really like when you take your time to tell me something!  I love to hear your stories!"

What can I do about word retrieval problems?

In addition to these fluency enhancing techniques, there are several games you could play at home to improve your child's vocabulary organization (we SLPs call this semantic mapping) which can aid in faster word retrieval with the hope to result in fewer dysfluencies.

1. Categories Games:  Labeling objects in a category can help organize words within your child's brain.  So you can print out pictures and have your child group them in piles that belong together (ex.  horse, cow, duck, sheep-go on a picture of a barn, where as apples, bananas, grapes, and watermelon-go on picture of a plate, etc.).  Or if you are out and about and don't have any pictures with you, can you can always play this in a verbal game format.  Eg. "Name three farm animals/tools/pieces of furniture/things you find in the bathroom, etc.).  Here a link to some free categories games you can play with  your child...just print out and play...from Let's Talk Speech-Language Pathology 
2. Guessing Games:   I love guessing games, and do them all the time with my son when we are stuck in line at the grocery store or waiting for our food at a restaurant.  You and your child take turns describing an object by its attributes and the other person guesses the object.  Eg.  "I'm thinking of an animal, it lives on a farm, it makes milk and it says 'moo'" or "I'm thinking of a fruit, it has a yellow peel, its shaped like a crescent moon, and monkeys like to eat them."  Here is a link to already made game where your child can sort descriptors with correct object also from Let's Talk Speech-Language Pathology...just print out and play.
3. Word Association Games:  You can do this with or without pictures...but for younger kids I prefer going on Bing or Google and putting some associated pictures on a word document, print it out, and cut them up separately to see if a child can pair up the right pictures (if you son is a reader you can just type associative word lists, cut and have him pair them).  Eg.  "scarf, glove", "toothpaste, toothbrush", "salt, pepper", etc.  Over the next week I will be posting some synonym and antonym games so stay tuned and you can download and print for free!
4. Synonyms/Antonyms games:   The simplest way to play these games without any pictures or props would be to have your child simple tell you if these two words mean the same thing or something different.  Eg.  "hot, warm"-same, "ugly, pretty"-different, etc.  Once your child is really good at that game you can have him think of two words and you can tell him if they are the same or different.  If you want to use a visual, you can always print out pictures and have him match them up.  On blog I have a dinosaur opposites bingo game you can just download and print if you want to use that.

There are just a few ideas of what you can do at home to help your child's word retrieval and enhance fluency. 

Should I be concerned?

You asked if you should be concerned.  I would become concerned if you try all of the above techniques and no improvement or even decline is noted!  Your child is still in that age range where dyfluencies can be typical in nature BUT you should see some improvement if you use the above techniques and activities.  Also if your child really struggles with participating in the above games, and is easily frustrated, I would urge you to follow up with an SLP immediately as that indicates some further difficulties in language development.

How do I get my child screened?

Call your school district or neighboring private practice SLP and ask for your child to be screened for speech and language skills with particular focus on his fluency.  Prior to screening, take video of your child's dysfluencies.  I will say that when I have to screen kiddos with a concern of stuttering, I really appreciate it if parents are able to take some video of their children prior to screening because IF your child doesn't exhibit any dysfluencies during the screening, I have no option but to send the child home as I have no evidence to determine need for further testing.

I hope this information has answered your question.  Feel free to comment me if you have additional ?s.

SLPs out there, if you read this and have other techniques feel free to comment below. Knowledge is power!

Happy Talking!